Covered California Insurance

Open Enrollment for private health coverage through Covered California in 2017 has closed.Special Enrollment is always open, see below.

Special Enrollment is always open for people who have a qualifying life event, to enroll in a Covered CA plan or make changes to their current plan. Coverage begins after completing the application process. Download Special Enrollment information slides here.

Medi-Cal: Remember that Medi-Cal is open all year and may be retroactive for medical services in the prior three months. Remind clients to respond to the Redetermination letter they have received from Medi-Cal to maintain their Medi-Cal status.

Good news! Pediatric Dental coverage is now included in Covered CA plans, ask your health insurance provider for more information.

Susana Castañeda, Patient Services Representative with SLO Public Health Department is a Certified Enrollment Counselor for Covered California health plans. She can be reached at 805-781-4838. Susana can also assist with Medi-Cal or the Medically Indigent Services Program (MISP).

To locate a Covered CA-certified insurance agent in your town, click here. Certified Insurance Agents may have specialized knowledge about which providers and medications are covered by each plan that would be helpful for people with more complex medical situations.

Income Levels

Access to sliding scale health insurance is available through Covered CA for adults with income levels between 138% and 400% of the Federal Poverty Level (FPL) and children with income levels between 250% and 400% of the FPL. The sliding scale cost is covered by advance premium tax credits. Eligibility for tax credits is determined using last year's FPL. The FPL is determined by the number of people in the household. To download 2017 FPL amounts (pdf file), click here. Adults and children with incomes below these amounts are eligible for Medi-Cal coverage.

Both individuals and families can purchase sliding-scale insurance through Covered CA. For example, if a child is covered by Medi-Cal, the parents can purchase insurance. Or if an adult has insurance through their employer, insurance for their child can be purchased through Covered CA if the employer does not offer dependent coverage.

Families with incomes above 400% of the FPL can also purchase policies through Covered CA or through an independent broker.